Moderate aortic stenosis: culprit or bystander?
Varayini PankayatselvanInbar RaberDavid PlayfordSimon StewartGeoffrey A StrangeJordan B StromPublished in: Open heart (2022)
Non-rheumatic aortic stenosis (AS) is among the most common valvular diseases in the developed world. Current guidelines support aortic valve replacement (AVR) for severe symptomatic AS, which carries high morbidity and mortality when left untreated. In contrast, moderate AS has historically been thought to be a benign diagnosis for which the potential benefits of AVR are outweighed by the procedural risks. However, emerging data demonstrating the substantial mortality risk in untreated moderate AS and substantial improvements in periprocedural and perioperative mortality with AVR have challenged the traditional risk/benefit paradigm. As such, an appraisal of the contemporary data on morbidity and mortality associated with moderate AS and appropriate timing of valvular intervention in AS is warranted. In this review, we discuss the current understanding of moderate AS, including the epidemiology, current surveillance and management guidelines, clinical outcomes, and future studies.
Keyphrases
- aortic stenosis
- aortic valve replacement
- aortic valve
- transcatheter aortic valve replacement
- transcatheter aortic valve implantation
- ejection fraction
- high intensity
- left ventricular
- atrial fibrillation
- coronary artery disease
- electronic health record
- type diabetes
- risk factors
- cardiac surgery
- public health
- cardiovascular disease
- percutaneous coronary intervention
- magnetic resonance
- acute coronary syndrome
- patients undergoing
- big data
- heart failure
- current status
- early onset
- risk assessment
- human health
- acute kidney injury
- case control
- drug induced
- deep learning